■川崎病是一种罕见的影响幼儿的血管炎。其病因尚不完全清楚,尽管感染经常被假定为触发因素。呼吸道病毒,具体来说,经常被认为是川崎病表现的病原体。
■我们旨在进行生态时空分析,以确定川崎病的发病率是否与共享地区和人群中的社区呼吸道病毒循环有关,并描述COVID-19大流行之前和期间的病毒关联。
■我们获得了在维多利亚州的两个大型医院网络中进行的川崎病和呼吸道多重聚合酶链反应测试的全州范围内的独立数据集,澳大利亚,从2011年7月到2021年11月。我们通过对维多利亚州不同地区川崎病的月发病率和呼吸聚合酶链反应试验阳性率的负二项回归分析,研究了时空关系。将病毒高峰季节(第95百分位数发病率)与中位病毒循环(第50百分位数发病率)进行比较,以计算高峰季节增加的比率。
■虽然在整个研究期间没有发现川崎病发病率的季节性趋势,我们发现1.52(99%CI1.27-1.82)和1.43(99%CI1.17-1.73)的川崎病表现与人偏肺病毒和呼吸道合胞病毒循环相关的比率增加,分别,在COVID-19大流行之前。在COVID-19大流行期间,未观察到呼吸道病毒与川崎病的关联。
■我们的大型生态分析证明了人类偏肺病毒和呼吸道合胞病毒循环与川崎病之间的新型时空关系。这些关联在COVID-19大流行中的消失可能反映了在此期间非SARS-CoV-2病毒的传播减少,支持本研究中确定的流行前关联。人类偏肺病毒和呼吸道合胞病毒在川崎病病因中的作用值得进一步研究。
UNASSIGNED: Kawasaki disease is an uncommon vasculitis affecting young children. Its etiology is not completely understood, although infections have been frequently postulated as the triggers. Respiratory viruses, specifically, have often been implicated as causative agents for Kawasaki disease presentations.
UNASSIGNED: We aimed to conduct an ecological spatiotemporal analysis to determine whether Kawasaki disease incidence was related to community respiratory virus circulation in a shared region and population, and to describe viral associations before and during the COVID-19 pandemic.
UNASSIGNED: We obtained independent statewide data sets of hospital admissions of Kawasaki disease and respiratory multiplex polymerase chain reaction tests performed at two large hospital networks in Victoria, Australia, from July 2011 to November 2021. We studied spatiotemporal relationships by negative binomial regression analysis of the monthly incidence of Kawasaki disease and the rate of positive respiratory polymerase chain reaction tests in different regions of Victoria. Peak viral seasons (95th percentile incidence) were compared to median viral circulation (50th percentile incidence) to calculate peak season increased rate ratios.
UNASSIGNED: While no seasonal trend in Kawasaki disease incidence was identified throughout the study period, we found a 1.52 (99% CI 1.27-1.82) and a 1.43 (99% CI 1.17-1.73) increased rate ratio of Kawasaki disease presentations in association with human metapneumovirus and respiratory syncytial virus circulation, respectively, before the COVID-19 pandemic. No respiratory viral associations with Kawasaki disease were observed during the COVID-19 pandemic.
UNASSIGNED: Our large ecological analysis demonstrates novel spatiotemporal relationships between human metapneumovirus and respiratory syncytial virus circulation with Kawasaki disease. The disappearance of these associations in the COVID-19 pandemic may reflect the reduced circulation of non-SARS-CoV-2 viruses during this period, supporting the prepandemic associations identified in this study. The roles of human metapneumovirus and respiratory syncytial virus in Kawasaki disease etiology warrant further investigation.